Management of Helicobacter Pylori Infection

Abstract

Substantial progress has been made in identifying the roles Helicobacter pylori (H. pylori) play in the pathogenesis of diseases that present clinically as dyspepsia, such as chronic gastritis, gastric ulcer, duodenal ulcer, gastric carcinoma, gastric mucosal associated lymphoid tissue (MALT) lymphoma, since its discovery by Warren and Marshall in 1982. This review aims at outlining the various diagnostic and therapeutic options available to the clinician in the management of H. pylori infection with an appraisal of their strength and weaknesses. Relevant literatures on diagnosis and treatment of H. pylori infection in texts and journals were reviewed. Extensive internet literature search was made through Google, Pubmed and HINARI. Effective diagnostic and multiple antimicrobial therapies are now available, although reliable antimicrobial monotherapy has been elusive. There is increasing resistance to the first line multiple antimicrobial therapies thereby necessitating a multistage approach to the management of the infection. Of note is the relatively new sequential therapy which has an eradication rate greater than 90%. Since an ideal therapy ought to be short and should lead to an eradication rate of the organism greater than 90%, the sequential therapy seems to have a potential of becoming the standard first-line treatment for H pylori infection in the interim, while search is being made for the ideal antimicrobial monotherapy.

Keywords: Helicobacter pylori, Dyspepsia, Gastric cancer, Gastric Ulcer, Duodenal ulcer